Form DD Form 1607 DD Form 1607 Application for Homeowners Assistance

Application for Homeowners Assistance

dd1607draft

Application for Homeowners Assistance

OMB: 0704-0463

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APPLICATION FOR DOD HOMEOWNERS ASSISTANCE PROGRAM
AUTHORITY
Public Law 89-754, Section 1013, as amended, authorizes the Secretary of Defense to provide financial assistance to eligible
homeowners serving or employed at or near military installations which were ordered closed or partially closed, realigned or were
ordered to reduce the scope of operations. This authority is referred to as "Conventional HAP - BRAC Causation".
Section 1001 of the American Recovery and Reinvestment Act of 2009 (ARRA), Public Law 111-5, temporarily expands authority
provided in 42 USC 3374 to provide assistance to: Wounded, injured, or ill members of the Armed Forces (30% or greater disability),
wounded Department of Defense (DoD) and US Coast Guard civilian homeowners reassigned in furtherance of medical treatment or
rehabilitation or due to medical retirement in connection with their disability, surviving spouses of fallen warriors, Base Realignment
and Closure (BRAC) 2005 impacted homeowners relocating during the mortgage crisis, and Service member homeowners undergoing Permanent Change of Station (PCS) moves during the mortgage crisis. This authority is referred to as "Expanded HAP".
This form is for applicants of either the Conventional HAP or Expanded HAP. Applicants cannot receive benefits and continue to
own the home. Benefits under either program are not available to temporary employees or contractor personnel. In addition to DD
Form 1607, additional documents may be required to determine HAP eligibility and benefits. Please contact the US Army Corps of
Engineers (CoE) District where your home is located (see map below) for specific information. PLEASE NOTE THE DEPARTMENT
OF DEFENSE WILL NOT BE RESPONSIBLE FOR SAFEKEEPING OR RETURN OF ORIGINAL DOCUMENTS.

D R A F T

Once you have completed your application - it must be reviewed by your personnel office, military or civilian, for verification of service
or employment records (see Section IV, Page 3) and mailed to the appropriate District Office of the CoE. The District CoE Office will
notify you when your application is received. If your application is determined to be ineligible, you will be notified by the District CoE
and will have the opportunity to appeal this decision. You can request a review of your case by requesting the appropriate District
forward your appeal to the HQUSACE (CEMP-CR). If application is further recommended for denial, HQUSACE will forward to the
Deputy Assistant Secretary of the Army for Installations & Housing (DASA(I&H)) for review and consideration. DASA(I&H) may
approve an appeal but must forward recommendations for denial to the Deputy Under Secretary of Defense for Installations &
Environment (DUSD(I&E)) for final recommendation.

FOR LOCATIONS IN:

CONTACT:
U.S. Army Engineer District, Sacramento, CESPK
1325 J Street
Sacramento, CA 95814-2922

Alaska, Arizona, California, Utah, Idaho, Oregon,
Pacific Ocean Rim, Washington, Montana, Nevada,
or Hawaii

(916) 557-6850 or 1-800-811-5532
Internet Address: http://www.spk.usace.army.mil
U.S. Army Engineer District, Fort Worth, CESWF
P.O. Box 17300
Fort Worth, TX 76102-0300

Arkansas, Louisiana, Oklahoma, Texas, New Mexico,
Colorado, Iowa, Nebraska, Minnesota, North and South
Dakota, Wisconsin, Wyoming, Kansas, or Missouri

(817) 886-1112 or 1-888-231-7751
Internet Address: http://www.swf.usace.army.mil

Georgia, North Carolina, South Carolina, Alabama, Mississippi,
Tennessee, Florida, Illinois, Indiana, Kentucky, Michigan, Ohio,
Maryland, Delaware, District of Columbia, Pennsylvania,
Virginia, Rhode Island, New York, Vermont, New Hampshire,
Massachusetts, Connecticut, Maine, New Jersey,
West Virginia, or Europe

DD FORM 1607 INSTRUCTIONS, 20100204 DRAFT

U.S. Army Engineer District, Savannah, CESAS
ATTN: RE-AH
P.O. Box 889
Savannah, GA 31402-0889
1-800-861-8144
Internet Address:
http://www.sas.usace.army.mil/hapinv/index.html

PREVIOUS EDITION IS OBSOLETE.

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OMB No. 0704-0463
OMB approval expires

APPLICATION FOR HOMEOWNERS ASSISTANCE
(Read Privacy Act Statement and Instructions before completing form.)

REPORT CONTROL SYMBOL

DD-A&T(AR)1154

The public reporting burden for this collection of information is estimated to average 1 hour per response, including the time for reviewing instructions, searching existing data sources, gathering and
maintaining the data needed, and completing and reviewing the collection of information. Send comments regarding this burden estimate or any other aspect of this collection of information, including
suggestions for reducing the burden, to the Department of Defense, Washington Headquarters Services, Executive Services Directorate, Information Management Division, 1155 Defense Pentagon,
Washington, DC 20301-1155 (0704-0463). Respondents should be aware that notwithstanding any other provision of law, no person shall be subject to any penalty for failing to comply with a
collection of information if it does not display a currently valid OMB control number.

PLEASE DO NOT RETURN YOUR FORM TO THE ABOVE ORGANIZATION. RETURN COMPLETED FORM TO THE APPROPRIATE ARMY CORPS OF ENGINEERS
OFFICE.

PRIVACY ACT STATEMENT
AUTHORITY: Public Law 89-754, Section 1013 and Executive Order 9397.
PRINCIPAL PURPOSE(S): To determine eligibility for benefit and process requests for the Homeowners Assistance Program.
ROUTINE USE(S): In addition to those disclosures generally permitted under 5 U.S.C. 552a(b) of the Privacy Act, these records or information contained therein may
specifically be disclosed outside the DoD as a routine use pursuant to 5 U.S.C. 552a(b)(3) including the Department of Housing and Urban Development when assuming
custody of acquired homes, to manage and dispose of such properties on behalf of the Secretary of Defense; Department of Veterans Affairs in accepting subsequent
purchaser in private sales when property is encumbered by a mortgage loan guaranteed or insured by them; Department of Justice to review final title and deeds of
conveyance to the Government for properties acquired under the program, pursuant to their responsibilities under Public Law 91-393; and the Internal Revenue Service
to determine tax liability for sale of property to the Government.
DISCLOSURE: Voluntary; however, failure to provide requested information will hinder verification of employment and homeowner information and may result in delay or
denial of benefits provided under this law.

Please type or print, limiting each entry to the space provided. If there is not enough space for an answer, use the "Remarks" section on Page 4 of
this form. Repeat the item number and give the additional information. If a date is required, enter year, month and day (for example, June 1, 2008
would be 20080601). Complete all sections of the form as indicated.
SECTION I - QUALIFICATION (To be completed by Applicant)
1. NAME (Last, First, Middle Initial)

2. SOCIAL SECURITY NUMBER

3. GRADE/RANK

b. CITY

c. STATE

4. PRESENT MAILING ADDRESS
a. STREET (Include apartment number)

d. ZIP CODE

D R A F T

5. EMAIL ADDRESS

6. HOME TELEPHONE NUMBER (Include area code)

7. WORK TELEPHONE NUMBER (Include area code)

a. HOME

a. COMMERCIAL

b. CELL

b. DSN

8. INSTALLATION/ACTIVITY ANNOUNCED FOR CLOSURE OR REDUCTION IN SCOPE (BRAC applicants only)
a. NAME OF INSTALLATION/ACTIVITY

b. CITY

c. STATE

9. DATE OF CLOSURE OR
REDUCTION ANNOUNCEMENT (BRAC) (YYYYMMDD)

10. EMPLOYMENT OR SERVICE AT INSTALLATION (Military and Federal Employee Applicants only)
a. ELIGIBILITY CATEGORY (X)
b. (X one)
c. BRANCH OF SERVICE. (X one)
WOUNDED

CSRS

ARMY

MARINE CORPS

BRAC

FERS

NAVY

COAST GUARD

PCS

NAFI

AIR FORCE

OTHER (Specify)

d. STARTING DATE (YYYYMMDD)

e. TYPE OF APPOINTMENT

f. ENDING DATE (YYYYMMDD)

g. NATURE OF SEPARATION

11. REASON FOR DESIRING ASSISTANCE (Complete 11.a. if Civilian Employee, 11.b. if Military Service Member)
a. CIVILIAN EMPLOYEE (X and complete as applicable)
(2) WOUNDED, INJURED OR ILL (WII)

(1) ACCEPTED FEDERAL TRANSFER
(a) FOR BRAC OR WII (Name of Installation or Hospital)

(b) DATE
(YYYYMMDD)

(3) SURVIVING SPOUSE

(c) LOCATION OF INSTALLATION (City, State, Country)

(4) ACCEPTED OTHER EMPLOYMENT (BRAC applicants only)
(a) AT (Name of Subsequent Employer)

(b) DATE
(YYYYMMDD)

(c) LOCATION OF EMPLOYMENT (City, State, Country)

(5) UNEMPLOYED (Furnish unemployment dates only when application is based on financial hardship due to your
inability to be employed in the area of the closed/reduced installation. Attach statement on why employment is not
available or has not been accepted; also state amount and frequency of all income, nature and amount of debts,
number and amount of installment payments (including mortgage) in arrears, and any other information providing
evidence of financial hardship.)

(a) UNEMPLOYED FROM (YYYYMMDD)

(b) TO (YYYYMMDD)

b. MILITARY SERVICE MEMBER (X and complete as applicable)
(1) TRANSFERRED TO: (a) NAME OF INSTALLATION

(b) DATE (YYYYMMDD)

(2) ORDERED INTO ON-POST QUARTERS ON (YYYYMMDD)
(3) PCS ORDERS (YYYYMMDD)
(4) RETIRED OR SEPARATED ON (YYYYMMDD)

DD FORM 1607, 20100204 DRAFT

Page 1 of 4 Pages

SECTION II - PROPERTY FOR WHICH ASSISTANCE IS SOUGHT
If home was SOLD, provide a copy of the Form HUD-1 (closing statement) (OMB Approval No. 2502-0265) of sale, and the deed with the recording
information such as Book and Page Number. If FORECLOSED or in process of foreclosure, provide a statement of obligations ensuing from foreclosure. Documents provided in evidence of purchase, sale, and foreclosure must be legible, completed copies.
THE DEPARTMENT OF DEFENSE IS NOT RESPONSIBLE FOR SAFEKEEPING OR RETURN OF ORIGINAL DOCUMENTS.
12. ADDRESS OF PROPERTY
a. STREET

b. CITY

14. IF MORTGAGED, WAS IT (X one)

13. PERIOD OF OWNERSHIP/OCCUPANCY
a. FROM (YYYYMMDD)

16. DATE OF PURCHASE
(YYYYMMDD)

c. COUNTY

b. TO (YYYYMMDD)

17. PRICE

d. STATE

e. ZIP CODE

15. PRESENT STATUS (X one)

FHA - INSURED

OWNED BY YOU (Complete Item 21)

VA - GUARANTEED

SOLD (Complete Item 22)

OTHER

FORECLOSED (Complete Item 23)

18. DEED IS RECORDED IN
a. VOLUME

b. PAGE

c. DEED RECORDS OF

19. APPROXIMATE DISTANCE FROM RESIDENCE TO WORK:
20. LIST MAJOR IMPROVEMENTS MADE BY YOU DURING YOUR OWNERSHIP (Such as adding garage, finishing rooms, adding bathroom, or other
improvements. Include cost and approximate date each was completed. Please specify whether improvements were made using home equity lines of credit or
additional mortgages.)

D R A F T
21. IF DWELLING IS OWNED BY YOU: (X and complete as applicable)
a. YOU STILL OCCUPY

c. PLAN TO SELL ON PRIVATE MARKET

b. VACANT

d. LEASED (Attach copy of lease)

(1) LEASED THROUGH (YYYYMMDD)

(2) LEASE AMOUNT (Per month)

b. DATE SOLD (or will close)
(YYYYMMDD)

c. SALE PRICE

22. IF DWELLING WAS SOLD:
a. SOLD TO

d. DEED RECORDED IN
(1) VOLUME

(2) PAGE

(3) DEED RECORDS OF

23. IF LIENHOLDER FORECLOSED ON PROPERTY:
a. DATE FORECLOSURE COMMENCED
(YYYYMMDD)

b. COMMENCED BY (X one)
VA

c. PROCEEDING STILL PENDING (X one)
YES

BANK (Name of Bank)

FHA
d. NAME OF COURT

e. LOCATION OF COURT

f. DATE OF FORECLOSURE SALE (YYYYMMDD)

g. AMOUNT OF FORECLOSURE SALE

NO

h. AMOUNT OF ENFORCEABLE LIABILITIES AGAINST YOU

24. IF YOU PLAN TO ASK THE GOVERNMENT TO PURCHASE YOUR DWELLING (Mortgages):
b. ADDRESS
(Street, City, State, ZIP Code)

a. LENDER NAME

c. ORIGINAL
AMOUNT

d. CURRENT
BALANCE

e. DATE OF LOAN
(YYYYMMDD)

1st

2nd

3rd

4th

f. DATE DWELLING WAS
CONSTRUCTED (YYYYMMDD)

g. TO THE BEST OF YOUR KNOWLEDGE, DOES THE DWELLING CONTAIN ENVIRONMENTAL HAZARDS?
(Such as friable asbestos, lead-based paint, etc.)
YES (Specify)
NO

DD FORM 1607, 20100204 DRAFT

Page 2 of 4 Pages

25. (BRAC APPLICANTS ONLY) POINT OF CONTACT TO ALLOW GOVERNMENT CONTRACTORS TO GAIN ACCESS TO YOUR DWELLING
(For Army Corps of Engineers' appraiser and inspector for environmental hazards)
a. NAME (Last, First, Middle Initial)

b. HOME TELEPHONE (Include area code)

c. WORK TELEPHONE (Include area code)

(2) CITY

(3) STATE

d. ADDRESS
(1) STREET (Include apartment number)

(4) ZIP CODE

26. POINT OF CONTACT THAT KNOWS YOUR WHEREABOUTS AT ALL TIMES (Someone who does not live with you)
b. HOME TELEPHONE (Include area code)

a. NAME (Last, First, Middle Initial)

SECTION III - DECLARATION
CRIMINAL PENALTY FOR PRESENTING FRAUDULENT CLAIM OR MAKING FALSE STATEMENTS
Fine of not more than $10,000 or imprisonment for not more than 5 years or both (See 62 Stat. 698, 749; 18 USC 287, 1001).
CIVIL PENALTY FOR PRESENTING FRAUDULENT CLAIM
The applicant shall forfeit and pay to the United States the sum of not less than $5,000 and not more than $10,000 plus 3 times the
amount of damages sustained by the United States (See 31 USC 3729).
27. I DECLARE UNDER THE PENALTIES OF PERJURY THAT THE INFORMATION PROVIDED BY ME HEREIN AND ATTACHED IS TRUE AND
COMPLETE TO THE BEST OF MY KNOWLEDGE AND BELIEF.
a. I APPLY FOR HOMEOWNERS ASSISTANCE IN THE FOLLOWING CATEGORY: (X as applicable)
(1) FORECLOSURE RELIEF (For applicants whose homes have been foreclosed)
(2) REIMBURSEMENT FOR LOSS ON PRIVATE SALE (For applicants whose homes have been sold or who plan to sell)
(3) GOVERNMENT ACQUISITION (For applicants who still own their homes) (Not available in foreign countries)

I voluntarily request and give my consent to the disclosure of my personal information. I am aware that I may revoke my consent at any
time by doing so in writing. This Consent is valid for one year from the date of authorization.
b. SIGNATURE (To be used in all future correspondence)

c. DATE SIGNED (YYYYMMDD)

SECTION IV - VERIFICATION OF EMPLOYMENT OR SERVICE (To be completed by Personnel Office)
28. REVIEW OF APPLICANT'S OFFICIAL PERSONNEL FOLDER INDICATES: (X and complete as applicable)
a. THE EMPLOYMENT/SERVICE INFORMATION SHOWN ON THIS FORM HAS BEEN VERIFIED AND IS CORRECT AS STATED IN ITEMS 1, 8, AND 10.
b. THE EMPLOYMENT/SERVICE INFORMATION SHOWN ON THIS FORM IS NOT CORRECT. THE PERSONNEL FOLDER SHOWS THE FOLLOWING:

D R A F T

29. PERSONNEL OFFICER
a. NAME (Last, First, Middle Initial)

b. TITLE

c. UNIT ADDRESS
(1) STREET

d. SIGNATURE

DD FORM 1607, 20100204 DRAFT

(2) CITY

(3) STATE

(4) ZIP CODE

e. DATE SIGNED (YYYYMMDD)

Page 3 of 4 Pages

SECTION V - REMARKS (To be completed as necessary. Reference each entry by item number.)

D R A F T

DD FORM 1607, 20100204 DRAFT

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